Healthcare Provider Details

I. General information

NPI: 1588372239
Provider Name (Legal Business Name): DR. AARON MATTHEW SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10635 MACCORKLE AVE
MARMET WV
25315-1963
US

IV. Provider business mailing address

11161 COAL RIVER RD
SAINT ALBANS WV
25177-8883
US

V. Phone/Fax

Practice location:
  • Phone: 304-949-3045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0013406
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: